Improving the completeness of structured MRI reports for rectal cancer staging
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Improving the completeness of structured MRI reports for rectal cancer staging Anna H. Zhao1 · Shanna A. Matalon1 · Atul B. Shinagare1 · Leslie K. Lee1 · Giles W. Boland1 · Ramin Khorasani1 Received: 21 June 2020 / Revised: 25 August 2020 / Accepted: 3 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Assess the impact of a multifaceted intervention to improve the completeness of structured MRI reports for patients undergoing initial staging for rectal cancer. Methods This Institutional Review Board-approved retrospective study was performed at a large academic hospital. MRI reports for initial staging of rectal cancer in 2017 and 2019 were analyzed pre- and post-implementation of multiple quality improvement interventions in 2018, including harmonizing MRI protocols across the institution, educational conferences and modules, and requiring second opinion consultation for all MRI rectal cancer examinations. The primary outcome measure was the completeness of rectal cancer staging MRI reports, classified as optimal, satisfactory, or unsatisfactory based on the inclusion of 15 quality measures pre-defined by a consensus of abdominal and cancer imaging subspecialists, colorectal surgeons, and radiation oncologists at our institution, based on published recommendations. Fisher’s exact test was used to evaluate changes in report quality and documentation of each quality measure. Results The study included 138 MRI reports, of which 72 (52%) were completed in 2017 pre-intervention. Post intervention, the proportion of optimal reports increased significantly from 52.8% (38/72) to 71.2% (47/66) (p = 0.035). Documentation of 1 quality measure (N stage) increased post intervention from 91.7% (66/72) to 100% (66/66) (p = 0.029). Documentation of 7 quality measures was 100% post intervention, with a documentation rate of > 95% for all quality measures except radial location of tumor. Conclusion A combination of educational and system-wide interventions was associated with an improvement in the completeness of structured MRI reports for rectal cancer staging. Keywords Rectal cancer staging MRI · Report quality · Structured report template · Multifaceted interventions
Introduction Colorectal cancer is the third most common cancer, with an estimated 104,610 cases of colon cancer and 43,340 cases of rectal cancer leading to 53,200 deaths in the United States in 2020 [1]. Rectal MRI plays a key role in the staging of rectal cancer. It provides valuable information including tumor and nodal staging, location, size, and morphology as well as involvement of the mesorectal fascia, sphincter complex, * Anna H. Zhao [email protected] 1
Department of Radiology, Center for Evidence‑Based Imaging, Brigham and Women’s Hospital/Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
adjacent organs, and vasculature [2–5]. This information is essential for determining surgical approach, prognosis, and whether neoadjuvant chemoradiother
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